Contextual risk factors for hepatitis C among young persons who inject drugs

青少年注射吸毒者发生丙型肝炎的背景危险因素

• 批准号: 10179349
• 负责人: Basmattee Boodram
• 金额: $ 52.6万
• 依托单位: UNIVERSITY OF ILLINOIS AT CHICAGO
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10179349
• 关键词: Address; Affect; Age; Area; Automobile Driving; Behavior; Behavioral; Characteristics; Chicago; Communities; Complex; Computer Models; Country; Data; Development; Disadvantaged; Disease Outbreaks; Drug usage; Ego; Epidemic; Exhibits; Generations; Geographic Factor; Geography; Goals; HIV/HCV; Hepatitis C; Hepatitis C Antiviral; Hepatitis C Incidence; Hepatitis C Prevalence; Hepatitis C Therapy; Hepatitis C Transmission; Hepatitis C virus; Illinois; Individual; Injecting drug user; Injections; Intervention; Investigation; Link; Location; Longitudinal Studies; Measures; Mediating; Methods; Needle Sharing; Needle-Exchange Programs; Neighborhoods; Not Hispanic or Latino; Participant; Pattern; Persons; Pharmaceutical Preparations; Phase; Pilot Projects; Population; Prothrombin; Public Health; Reporting; Research; Research Personnel; Risk; Risk Behaviors; Risk Factors; Rural; Rural Community; Site; Social Network; Structure; Testing; Thromboplastin; Time; United States; United States Dept. of Health and Human Services; United States National Academy of Sciences; Viral hepatitis; contextual factors; density; drug market; epidemiology study; high risk; high risk behavior; improved; injection drug use; innovation; interest; member; novel strategies; outreach; prescription opioid misuse; recruit; residence; rural area; scale up; sex; social; social norm; social stigma; social structure; sociodemographics; suburb; suburban communities; support network; time use; trend; viral transmission

7. PROJECT SUMMARY Background: An emerging epidemic of hepatitis C virus (HCV) infection exists among young persons who inject drugs (PWID) from suburban and rural areas. HCV is primarily transmitted via risk practices associated with injection drug use (IDU). In 2016, the National Academy of Sciences (NAS) examined the feasibility of HCV elimination in the U.S., defined as cessation of viral transmission in this country. In its phase-1 report, NAS determined that young PWID are the people at greatest risk for HCV and are the primary drivers of HCV incidence today in non-urban U.S. communities that previously had low to modest rates of HCV infection. To date, no known study has fully elucidated why HCV incidence is increasing in this “new generation” of PWID (NG-PWID), which is composed predominantly of non-Hispanic Whites from suburban and rural communities. Our recent study suggests that what may have changed over the past decade are contextual and structural factors that heighten suburban NG-PWID's risk of becoming HCV-infected. Objective: We propose a longitudinal study among NG-PWID and their personal (egocentric) injection, sexual, and support networks. We will collect data every 6 months for 36 months to assess over time the impact on HCV risk of (i) social network factors, (ii) physical and social geographic factors, (iii) social norms of IDU, and (iv) perceived IDU and HCV stigma. Methods: We will recruit 420 PWID (ages 18-30) and about 1,156 of their injection network members (age 18 and over) from Chicago, Illinois, and surrounding suburban areas. Recruitment will occur at two community field sites of a large syringe services program (SSP) and through direct outreach in large, open drug market areas. Six types of data will be collected on both participants and their injection, sexual, and support network members: (i) participant socio-demographic characteristics, drug use patterns and practices, and sexual practices, (ii) network size, characteristics, and features of relationships among network members (e.g., strength of tie), (iii) HIV and HCV infection status through testing, (iv) geographic data on the location and characteristics of places where participants and their network members reside, purchase drugs, inject, and meet sex and injection partners, (v) an assessment of social norms within both the participant's network and specific behavioral settings, and (vi) an assessment of perceived IDU and HCV stigma. Public Health Significance: The proposed research will (i) improve our understanding of the contextual and structural factors driving HCV incidence among NG-PWID, (ii) inform the development of innovative strategies for NG-PWID (e.g., network interventions, direct antiviral HCV treatment scale up) toward the goal of HCV elimination in the U.S. set forth by DHHS, and (iii) provide crucial data needed to develop more realistic computational models that address the complex interplay of individual, social, and structural level factors affecting HCV incidence in order to identify the most effective combination(s) of intervention strategies for achieving HCV elimination.

7. 项目概要 背景：丙型肝炎病毒 (HCV) 感染在年轻人中呈新流行趋势， 来自郊区和农村地区的注射吸毒者 (PWID) 主要通过相关风险行为传播。 2016 年，美国国家科学院 (NAS) 研究了注射吸毒的可行性。 美国消除丙肝病毒，定义为该国病毒传播的停止。在其第一阶段报告中， NAS 确定年轻吸毒者是丙肝病毒感染风险最大的人群，也是丙肝病毒的主要驱动因素 以前 HCV 感染率较低至中等的美国非城市社区如今的发病率较高。 迄今为止，尚无已知研究完全阐明为何“新一代”吸毒者中丙型肝炎病毒发病率不断增加 (NG-PWID)，主要由来自郊区和农村社区的非西班牙裔白人组成。 我们最近的研究表明，过去十年可能发生的变化是背景和结构 增加郊区 NG-PWID 感染 HCV 风险的因素 目标：我们提出了一个建议。 NG-PWID 及其个人（以自我为中心）注射、性和支持网络的纵向研究。 我们将在 36 个月内每 6 个月收集一次数据，以评估随着时间的推移，以下因素对 HCV 风险的影响： 网络因素，(ii) 物理和社会地理因素，(iii) IDU 的社会规范，以及 (iv) 感知的 IDU 和 方法：我们将招募 420 名注射吸毒者（18-30 岁）和他们注射网络中的约 1,156 名注射者。 来自伊利诺伊州芝加哥及周边郊区的会员（18 岁及以上）招募地点为： 大型注射器服务计划 (SSP) 的两个社区现场站点，以及通过大型、开放的直接外展 将收集有关参与者及其注射、性和行为的六种类型的数据。 支持网络成员：(i) 参与者的社会人口特征、吸毒模式和做法， 和性行为，(ii) 网络规模、特征以及网络成员之间关系的特征 （例如，联系的强度），(iii) 通过检测获得的 HIV 和 HCV 感染状况，(iv) 有关地点和地点的地理数据 参与者及其网络成员居住、购买毒品、注射和注射毒品的地方的特征 与性伙伴和注射伙伴会面，(v) 对参与者网络内的社会规范进行评估， 具体的行为环境，以及 (vi) 对注射吸毒者和丙型肝炎病毒耻辱感的评估。 意义：拟议的研究将（i）提高我们对背景和结构因素的理解 推动 NG-PWID 中的 HCV 发病率，(ii) 为 NG-PWID 创新战略的制定提供信息 （例如，网络干预、扩大直接抗病毒 HCV 治疗规模）以实现消除 HCV 的目标 美国由 DHHS 提出，并且 (iii) 提供开发更现实的计算模型所需的关键数据 解决影响 HCV 发病率的个人、社会和结构层面因素的复杂相互作用 以确定实现消除 HCV 的最有效的干预策略组合。

项目成果

A Novel Index Measure of Housing-related Risk as a Predictor of Overdose among Young People Who Inject Drugs and Injection Networks.

住房相关风险的新指数测量作为注射毒品和注射网络青少年吸毒过量的预测指标。

• 发表时间: 2023-06-26
• 作者: Kristensen, Kathleen;Williams, Leslie D;Kaplan, Charlie;Pineros, Juliet;Lee, Eunhye;Kaufmann, Maggie;Mackesy;Boodram, Basmatee
• 通讯作者: Boodram, Basmatee